Pan-intestinal capsule endoscopy in patients with postoperative Crohn's disease: a pilot study. (3rd August 2017)

• Record Type: Journal Article
• Authors: Hausmann, Johannes; Schmelz, Renate; Walldorf, Jens; Filmann, Natalie; Zeuzem, Stefan; Albert, Jörg G.
• Is Part Of: Scandinavian journal of gastroenterology. Volume 52:Number 8(2017)
• Page Start: 840
• Page End: 845
• Publication Date: 2017-08-03
• Subjects: Colon capsule endoscopy -- endoscopy -- colonoscopy -- second-generation colon capsule -- Crohn's disease -- postoperative management; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; 616.33
• DOI: 10.1080/00365521.2017.1310289
• Languages: English
• ISSNs: 0036-5521

Abstract

Abstract: Background: Patients are at increased risk of disease recurrence after surgical treatment of Crohn's disease. Endoscopic detection of postoperative, ileo-colonic inflammation is well established, but the potential of pan-intestinal endoscopy is yet unknown. Methods: This prospective multicenter pilot study assessed the value of pan-intestinal capsule endoscopy using a colon capsule endoscope for the detection of inflammatory recurrence of Crohn´s disease. Patients who had been operatively treated for Crohn´s disease were included. Colon capsule endoscopy was performed 4–8 weeks ( d 1) and 4–8 months ( d 2) postoperatively together with ileo-colonoscopy at d 2 using a modified Ruttgeerts index for evaluating disease activity. Results: Twenty-two patients were included into this study. At d 1, significant disease activity (Ruttgeerts index ≥2) was detected in 3/16 (19%) of the patients. At d 2, half of the patients (6/12) showed active disease, whereas ileo-colonoscopy revealed significant inflammation in 5/15 (33%). All patients rated as having active disease by ileo-colonoscopy had been revealed by PICE as well. These findings influenced the medical treatment in every case. Conclusion: Pan-intestinal capsule endoscopy seems to be feasible in the postoperative surveillance of Crohn's disease. Disease activity is reliably detected. Especially, the findings in the small bowl might be a significant advantage in comparison to ileo-colonoscopy, as they can have significant impact on clinical management. Further studies with a larger number of patients are needed to confirm these findings and might lead to a replacement of the flexible ileo-colonoscopy with pan-intestinal capsule endoscopy in this indication in the future.